Probably, one of the main outcomes of contemporary medicine is the increasing duration of life. Doubtlessly, this is a complex outcome depending on so many factors. But we can hypothesize up to what extent our job contributes to this result. Nonetheless, the converse is something readily verifiable: as a population grows old, needs and ways for clinical medicine are challenged dramatically.
In the world of today, this issue poses a considerable amount of pressure upon several aspects: neurodegenerative diseases, cancer prevention and treatment, and cardiometabolic medicine, among others. I will say some words about the latter. We live in a world where so many are having the unprecedented experience of living so long. That’s obviously good news, but that’s not all the story.
It is in the second half of our lives that we seek medical attention for so many conditions. Conditions that can and must be treated with – but not only – drugs. Patients often take many drugs that have interactions and untoward effects. So, it is by no means surprising that they have so many doubts about their treatment. In addition, it is a commonplace that diet modification is important. But, frequently, they receive scanty information about feasible modifications. Likewise, it would be desirable to know more about exercise, adapted to real possibilities. But it is guessed that we doctors have a problem of time disposition and management almost everywhere.
Probably, more time is needed in the assistance of cardiometabolic patients. We need more time to seek hypo reactions complicating adherence. We haven’t got time enough to assess the impact of a given combination of antihypertensive drugs. So little time to assess if a drug dose should be decreased, augmented, or simply withdrawn. Almost no time to listen what real possibilities do exist to do some exercise in the surroundings. Almost no time either to listen what the patient is actually eating, and what should be modified before changing to this drug or the other. No time to let him or her know the importance of the condition and the need to undertake a proactive behavior about the issue. So little time for treating him or her like a person with diabetes, with a personal experience and a point of view. Rather, some minutes to fulfill the clinical record, and apply him or her the corresponding algorithm relating to his or her diabetes, spending a few seconds to communicate him or her what the System has to offer.
In this regard, it is to question if modern medicine has become a frustrating experience for both, the patient and the physician, at least for so many. It is also to question why so many doctors – so intelligent, so prepared – in so many countries have let this to happen without a protest.